Need Management Therapy: A Clinical GPS for Couples Work

Need Management Therapy: A Clinical GPS for Couples Work

by Robert N. Johansen
Discover a new tool for navigating a successful, safe therapeutic route through the volatile atmosphere of couples therapy.

NEW LOW PRICING!
Video Memberships for personal viewing.
Access to over 300 of the best psychotherapy
training videos starting at $29/month.

 

 

A new couple enters my office, and instantly I sense a faint but still discernible vestige of feelings dating to my early years as a fledgling psychologist. In those days, couples therapy struck me as overwhelmingly rife with complexities and sundry conundrums, all charged with intense, volatile emotion. Like the wild, erratic dance of a fallen power line, couples would fling verbal darts and threatening accusations at each other. On too many occasions, I felt stunned and intimidated under the full, onerous weight of my inexperience.

The Woes of Being Novice

My novice, impoverished clinical efforts were wobbly, halting and stumbling. I confess, there were moments where, not knowing how to helpfully involve myself, I froze in a stasis I called “interventional paralysis.” Even more regrettably, there was that notorious—and seemingly inevitable—disastrous session where, failing to harness the couple’s rage, both partners bolted inconsolably from my office, leaving me in their frenzied wake feeling deeply discouraged and clinically impotent.

on too many occasions, I felt stunned and intimidated under the full, onerous weight of my inexperience
Notwithstanding, these haunting professional nightmares ultimately proved to be de facto growing pains that richly informed me in crafting a treatment approach to couple’s therapy, a new GPS for navigating the craggy but fulfilling landscape of the couple relationship.

Too often, it’s been my experience that distressed couples present to treatment desperately teetering on a precipice of separation and divorce, compelling me to make a quick, hopefully effective “first-responder” application of treatment an urgency. But even under ordinary, non-emergency circumstances, it has become increasingly evident to me that the intimate relationship delivers a steady supply of challenges, some of which are Sisyphean-like in difficulty. Arguably, intimacy is in a league of its own, no other relationship compares in complexity, difficultly, nor fulfillment. Yet oddly, there are no formal institutions that prepare us for it, nor are there standardized marital manuals offering precise, dependable, science-based guidelines.

Nevertheless, despite its predictable ruggedness, intimacy still promises us life’s loftiest personal rewards and its greatest joys. The question is, what are the best tools for harvesting them? Both personally and professionally, I feel there’s a glaring need for a reliable GPS for navigating a successful, emotionally safe therapeutic route through intimacy’s uneven, often hazardous terrain, which is characteristically pocked with conflict, frustration, and disappointment. So, out of arguable necessity, this proposed GPS is intended to serve the practicing clinician, their couple clients, and, for that matter, anyone partnered within an intimate relationship.

A New, Brighter Day

Fortunately, things are much different for me today. Now, when couples present for treatment, my overriding feeling is best described as clinical self-assuredness, born, no doubt, of greater experience. However, I’m convinced the lion’s share of it derives from my growing confidence in the new couples therapy model I’ve added to my clinical tool belt. With equal portions of relief and gratitude, I’m now more prepared to helpfully intervene. Perhaps just as importantly, my clinical confidence is transmissible, that is, it can be emotionally infectious, like a positive contagion that boosts a couple’s confidence in the therapy process. Amusingly, Bruce Wampold alleged that the clinician’s conviction of the efficacy of their treatment strategies is, in itself, therapeutically powerful, likening it to a witch doctor’s “curative” influence. Similarly, at the risk of sounding clinically omniscient or lacking in humility, neither of which embraces scientific objectivity, I have come to feel especially prepared and confident in this approach. This GPS, as I’ve nicknamed it, was born largely of my earlier feelings of being lost and in need of firm grounding and direction when working with couples struggling with intimacy and embroiled in conflict.

it’s been my experience that distressed couples present to treatment desperately teetering on a precipice of separation and divorce
If you were to join me in my office, looking over my shoulder, you’d see that I’m especially watchful of a common tendency among partners to target one another with vilifying, non-specific complaints and vague, undefined references to their cripplingly poor communication habits. Commonly, couples seem all too happy to showcase their partner’s faults, foibles and imperfections, but rarely their own. And the accuser’s finger-pointing is typically served up with an accompanying plateful of insinuations that their relationship would be better if only their partner were to change. Of course, this change is often defined exclusively by the partner making the allegation. Obviously, the couple’s ranting indictments of each other typically fail to bring significant, durable change, and finally out of growing despair and necessity, they drag their wounded relationship, kicking and screaming, into treatment.

So, frequently and to the couple’s surprise, I explain that they probably would not be at loggerheads with each other if either or both of them had brought invalid needs to the other. After allowing a moment for this thought to percolate, couples, almost without exception, accept the cogency of this premise, which, as can often be predicted, effectively prompts partners to ask themselves, “Why are we fighting, then?”

commonly, couples seem all too happy to showcase their partner’s faults, foibles and imperfections, but rarely their own
Next, with some active nudging, I encourage each partner to look below the attention-consuming mismanagement of their own need to their need’s deep taproot of legitimacy. For example, partners need to be heard in a respectful, sensitive way, which is without question valid, even sine qua non, but can easily be mismanaged, e.g., “You never listen to me!” Here, attention is drawn to the critical, judgmental tone of the complaint, which then mobilizes the taunted partner’s defenses, thus turning their attention away from the validity of their partner’s need to be heard.

Conversely, if the need to be understood were effectively managed, it would sound more like this: “When I feel heard, I feel respected, cared for, and I’d sure welcome your understanding now.” Clearly, there’s less economy of time and energy in the latter example, but its payoff is great and can be measured by increases in self and partner respect, and even an elevated probability of need gratification that rewards the added efforts of the need manager. I’ve found that partners who respect one another are more likely to gratify the other’s needs.

Need Management Therapy

Before I continue unspooling the specific steps of this model, be reassured that it has evolved over years in practice and flows from the work of pioneers in the field of couples therapy, including Aaron Beck, John Gottman, Sue Johnson, and Leslie Greenberg. My use of the acronym GPS is metaphorical, designed to be a catchy, descriptive epithet for the model, whose formal name is Need Management Therapy (NMT).

theoretically, or perhaps ideally, a couple is composed of two individual selves
Theoretically, or perhaps ideally, a couple is composed of two individual selves. While this may seem obvious, what is not so clear is the very concept of “the self,” which is up for definitional grabs; it’s a theoretical construct, and there are several competing versions of it lining the shelves of the scientific and self-help marketplaces. So, cautiously exercising my own theoretical prerogative, I’ve stepped out on a limb and defined the self as a composite of circulating needs of varying types and magnitudes. Further, by my calculations, human needs are self-defining, self-constructing psychodynamic entities that require active management, including the management of the feelings orbiting about them. These concepts have significant diagnostic and therapeutic implications, especially within the rigorous context of the intimate relationship. Convincingly, optimal individual and couple health can be realized by the effective management of both individual and shared needs and feelings.

In its simplest, most encapsulated form, NMT teaches the couple the tools necessary for the effective management of their needs and feelings. So, here’s a brief preview, a quick synopsis of NMT punched out in a one-to-three stepwise form. Later, I’ll further flesh out the model’s three lynchpin steps while fitting each one to a concrete couple example for a clear demonstration of how the steps are applied.

Step one is “need identification,” which endows partners with the Socratic “know thyself” advantages of self-delineation and self-cohesiveness. Step two is “need legitimization,” which assumes that partners bring fundamentally valid needs to one another and encourages partners to actively represent them. Step three, “need representation,” centers around creating and preserving self and partner esteem—legitimate needs must be given voice along with the feelings associated with them. This expression of the emotions encircling a partner’s needs amplifies the personal meaning of the need, and more, creates a deep connection within individual partners, predisposing a better quality of connection between partners.

Need Identification: The NMT therapist encourages the couple to identify the personal needs that each partner brings to the other, especially those that ignite conflict. To illustrate, consider the case of Justin and Stephanie. What ignited their most recent skirmish and finally drove them into treatment was Justin’s non-negotiated demand to purchase a mountain bike—his identified need. Stephanie had other plans. Her identified need was to replace the family’s aging car, which she thought ought to top their list of spending priorities. At this point, both partners identified their manifest needs.

Despite its propensity for generating couple conflict, this active process of need identification effectively constructs the self, and again, a well-constructed self bodes well for personal mental health and the health of the partnership. Poorly defined needs are more difficult to manage. Moreover, the intimate relationship confers immeasurable benefits upon its constituents, but it can also be notorious for its ability to dismantle personal identities, as partners often under-manage or fail to adequately manage their own needs. Sadly, these failings can occur for reasons related to a partner’s lack of self-acceptance and/or for understandable but misguided attempts to preserve couple peace and harmony by dodging conflict and reducing friction, which is always ill-advised.

Need Legitimization: NMT trumpets this bold presupposition: most, if not all, individual needs are fundamentally legitimate at their most basic, irreducible level; therefore, they cry out for active, effective expression and management. For example, partners have a deep-seeded need for sensitive, respectful understanding of their needs and feelings regardless of the nature of the need or the inevitable surface-level disparities between their own and their partner’s needs. Moreover, a partner’s failure to adequately imbue their personal needs with this fundamental legitimacy predisposes the non-or-undermanagement of their needs, creating a potential breeding ground of self and partner resentment. For example, if I fail to manage the valid needs I bring to my partner, this self-imposed forfeiture of my needs diminishes my self-respect. I’ve become someone less than I optimally ought to be, or who I fully am. Now, as a lessor presence in relation to my partner, a chink develops in my personal identity armor, and as a consequence I don’t like who I am vis-a-vis my partner. Conversely, by deliberately imbuing my needs with positive status, I elevate the probability of their active management. And, perhaps of greater value, I simultaneously spawn self- and even partner-respect as I bring a more defined, fuller version of myself to my partner that also ferries the additional advantage of invigorating and nourishing my relationship.

most, if not all, individual needs are fundamentally legitimate at their most basic, irreducible level; therefore, they cry out for active, effective expression and management
Referring back to the example of Justin and Stephanie, each partner brings a valid need to the other, and therefore each one ought to legitimize the others need, as opposed to entrenching themselves in a competitive or adversarial argument in which one partner’s need is pitched as more important than the other’s. When couples purposely legitimize their own and their partner’s needs, they create a mutuality of respect that can be immediately conflict-preemptive and even lay down a longer-term prophylaxis against future couple warfare. Moreover, this atmosphere of mutual respect paves the way for the usual problem-solving conventions of compromise, negotiation, bargaining or other quid-pro-quo options for resolving differences. A qualifying caveat to this is that all too often, partners rightfully assume their need is valid but wrongfully assume it should be gratified on the spot because of the legitimacy it holds for them. This all-to-common need mismanagement pitfall fails to calculate the fundamental validity of one’s partner’s needs and can thus seed couple conflict.

Partners could conceivably lock horns in perpetuity because each, at least from their own perspective, brings a valid need to the table. Do couples fight for reasons that are not valid? Not likely. Partners believe and, more importantly, feel their individual needs have importance, or else why express them, much less defend them, or worse still, launch their version World War Three over them? Couples fight not because they bring illegitimate needs to one another but rather because they fail to effectively manage their own basic needs and adequately validate those of their intimate other. According to NMT, poor personal need management is the crucial point d’origine, the epicenter of couple rancor, dispute, and conflict. And when couple dissension is relentless and protracted, the accumulation of the toxic emotional by-products of poor personal need management—frustration, hurt, betrayal, anger, confusion, disillusionment, depression, to name a few—disease the relationship, until it can become moribund and dies. Extending this NMT logic, could every heated argument, or every fight, be framed as an instance of poor individual need management? If so, in a perfect couple-world, where needs are well-managed, fighting would be nonexistent.

according to NMT, poor personal need management is the crucial point d’origine, the epicenter of couple rancor, dispute, and conflict
Need representation: After greasing the wheels of communication by respectfully requesting a dosing of their partner’s time and understanding—a necessary preliminary—each partner is then encouraged to express their needs in clear, understandable terms. But with even greater emphasis, couples are strongly coached to express the emotions whirling about their needs. A need’s personal “weight of meaning” is conveyed through this accurate expression of the feelings connected to it. As needs and their related feelings are expressed with sufficient depth and accuracy, partners achieve a profound connection within themselves, which, in turn, serves as a precursor to a deeply emotional connection between partners. In briefer terms, “I can be no closer to my partner than I am first close to myself.”

Lastly, partners are taught to prioritize the effective management of their needs over their gratification. To be sure, I’m all in favor of need gratification, but it should come via the steps of effective need management and therefore be of secondary importance. NMT holds that it is in the effective management of our needs, and not their gratification, that we develop our emotional maturity. In stark contrast, like an untamed and feckless reflex, the pursuit of immediate personal need gratification can harm partners, as it puts one partner’s need above the another’s, thus risking the moment-to-moment health of the relationship.

NMT holds that it is in the effective management of our needs, and not their gratification, that we develop our emotional maturity
Returning once more to the case of Justin and Stephanie, the third and final step of the model begins with a respectful investiture of partner respect prior to the expression of the need. For example, Justin might say to Stephanie, “Could I get a moment of your time?” or, “Are you real busy right now?” This common courtesy is a small investment in respect for Stephanie which literally credits Justin with a commensurate or reciprocating return of respect that can start the communicative ball rolling productively. Next, Justin makes plain his need for a mountain bike but, more importantly, he very purposely expresses the breadth and depth of his feelings related to his anticipated use of the bike. Lastly, and very importantly, Justin must strive to prioritize the management of his need for the bike over the immediate personal gratification of actually purchasing it. Challenging! But Justin’s goal is to learn that it’s the effective management of his need and not its gratification that ensures his maturation and growth and the preservation of the moment-to-moment health of his most prized relationship. The same exact process of effective need representation is repeated with Stephanie.

Adherence to this stepwise, simple orthodoxy of the NMT model can ensure growth in self and partner esteem as well as enhance the health of the relationship, meeting the highest needs of the individual. And, as an added incentive, good need management elevates the probability of personal need gratification.

A Personal Addendum

I have been deeply gratified and often immediately rewarded in “psychic dollars” as I’ve observed couples respond positively to NMT. Many times, within as few as one to five sessions, couple change occurs as partners learn to identify and validate the legitimacy of their needs by the deliberate, purposeful crowning of their needs with positive status. This process of self-generated validation of one’s needs can, and often does, encourage their active representation, and with it the door to a more fulfilled and maturing self is flung open.

Importantly, NMT theorizes that the intimate relationship is incomparable, like no other relationship because it creates the conditions by which the fullest maturation of the self can be realized. Outside its context, the same optimal emotional development may not be realizable. This is because of intimacy’s matchless features, chief of which is the endless stream of opportunities for personal growth through the development of effective need management skills.

By incorporating these simple, but compelling, principles into my treatment repertoire, I have been served a savory, delightful helping of clinical self-assuredness. But more importantly, I’ve witnessed the efficacy of this approach first-hand in the lives of the couples with whom I’ve worked. No more interventional paralysis, no more stumbling or bolting clients, and no more clinical nightmares!

© 2021 Psychotherapy.net, LLC
Bios
Robert N. Johansen Robert N. Johansen, PhD., is a member of the American Psychological Association and the co-director of the Cerritos Psychological Center, where he has been in practice for over forty years, specializing in couple’s therapy and supervising interns. Robert has coauthored two books on the new couple’s treatment model, Need Management Therapy and coauthored a professional journal article on the same model. He has taught at several universities and colleges including UCLA, and lectured at the Milton Erickson International Foundation, California Association of Marriage and Family Therapists, NPR, ABC radio, University of California Educational TV, and continuing education at Alliant International University. He has been married for forty-one years and has two adult children and three grandchildren. He enjoys traveling with his wife, tennis, restauranting, and going to the theater. This essay is based on the book Need Management Therapy (NMT): A New Science of Love, Intimacy, and Relationships by the author, Robert N. Johansen and Todd W. Gaffney (2021, Archway Publishing).